BACKGROUND: Measurements of upper airway size and shape are important in investigating the pathophysiology of obstructive sleep apnea (OSA) and in devising, applying, and determining the effectiveness of treatment modalities. We describe an endoscopic optical technique (anatomic optical coherence tomography, aOCT) that provides quantitative real-time imaging of the internal anatomy of the human upper airway. METHODS: Validation studies were performed by comparing aOCT- and computed tomography (CT)-derived measurements of cross-sectional area (CSA) in (1) conduits in a wax phantom and (2) the velo-, oro-, and hypopharynx during wakefulness in five volunteers. aOCT scanning was performed during sleep in one subject with OSA. RESULTS: aOCT generated images of pharyngeal shape and measurements of CSA and internal dimensions that were comparable to radiographic CT images. The mean difference between aOCT- and CT-derived measurements of CSA in (1) the wax phantom was 2.1 mm(2) with limits of agreement (2 SD) from -13.2 to 17.4 mm(2) and intraclass correlation coefficient of 0.99 (p < 0.001) and (2) the pharyngeal airway was 14.1 mm(2) with limits of agreement from -43.7 to 57.8 mm(2) and intraclass correlation coefficient of 0.89 (p < 0.001). aOCT generated quantitative images of changes in upper airway size and shape before, during, and after an apneic event in an individual with OSA. CONCLUSIONS: aOCT generates quantitative, real-time measurements of upper airway size and shape with minimal invasiveness, allowing study over lengthy periods during both sleep and wakefulness. These features should make it useful for study of upper airway behavior to investigate OSA pathophysiology and aid clinical management.
BACKGROUND: Measurements of upper airway size and shape are important in investigating the pathophysiology of obstructive sleep apnea (OSA) and in devising, applying, and determining the effectiveness of treatment modalities. We describe an endoscopic optical technique (anatomic optical coherence tomography, aOCT) that provides quantitative real-time imaging of the internal anatomy of the human upper airway. METHODS: Validation studies were performed by comparing aOCT- and computed tomography (CT)-derived measurements of cross-sectional area (CSA) in (1) conduits in a wax phantom and (2) the velo-, oro-, and hypopharynx during wakefulness in five volunteers. aOCT scanning was performed during sleep in one subject with OSA. RESULTS: aOCT generated images of pharyngeal shape and measurements of CSA and internal dimensions that were comparable to radiographic CT images. The mean difference between aOCT- and CT-derived measurements of CSA in (1) the wax phantom was 2.1 mm(2) with limits of agreement (2 SD) from -13.2 to 17.4 mm(2) and intraclass correlation coefficient of 0.99 (p < 0.001) and (2) the pharyngeal airway was 14.1 mm(2) with limits of agreement from -43.7 to 57.8 mm(2) and intraclass correlation coefficient of 0.89 (p < 0.001). aOCT generated quantitative images of changes in upper airway size and shape before, during, and after an apneic event in an individual with OSA. CONCLUSIONS: aOCT generates quantitative, real-time measurements of upper airway size and shape with minimal invasiveness, allowing study over lengthy periods during both sleep and wakefulness. These features should make it useful for study of upper airway behavior to investigate OSA pathophysiology and aid clinical management.
Authors: Miranda Kirby; Keishi Ohtani; Taylor Nickens; Rosa Maria Lopez Lisbona; Anthony M D Lee; Tawimas Shaipanich; Pierre Lane; Calum MacAulay; Stephen Lam; Harvey O Coxson Journal: Biomed Opt Express Date: 2015-10-14 Impact factor: 3.732
Authors: Harvey O Coxson; Brendan Quiney; Don D Sin; Li Xing; Annette M McWilliams; John R Mayo; Stephen Lam Journal: Am J Respir Crit Care Med Date: 2008-02-28 Impact factor: 21.405
Authors: Carole L Marcus; Richard J H Smith; Leila A Mankarious; Raanan Arens; Gordon S Mitchell; Ravindhra G Elluru; Vito Forte; Steven Goudy; Ethylin W Jabs; Alex A Kane; Eliot Katz; David Paydarfar; Kevin Pereira; Roger H Reeves; Joan T Richtsmeier; Ramon L Ruiz; Bradley T Thach; David E Tunkel; Jeffrey A Whitsett; David Wootton; Carol J Blaisdell Journal: Proc Am Thorac Soc Date: 2009-09-15
Authors: Anna C Bitners; Sanghun Sin; Sabhyata Agrawal; Seonjoo Lee; Jayaram K Udupa; Yubing Tong; David M Wootton; Kok Ren Choy; Mark E Wagshul; Raanan Arens Journal: Sleep Date: 2020-10-13 Impact factor: 5.849
Authors: Peter B Noble; Robert A McLaughlin; Adrian R West; Sven Becker; Julian J Armstrong; Peter K McFawn; Peter R Eastwood; David R Hillman; David D Sampson; Howard W Mitchell Journal: Respir Res Date: 2010-01-22